早期肠内免疫营养对烫伤大鼠免疫功能的影响

目的了解早期肠内免疫营养对烫伤大鼠全身及肠道免疫功能的影响。方法将健康SD大鼠分为标准营养组（EN组）和免疫营养组（EIN组），每组32只。将两组大鼠制成烧伤总面积30％TBSA的Ⅲ度烫伤模型，于伤后1、4、7、10d检测其外周血T淋巴细胞亚群、肠黏膜增殖细胞核抗原（PCNA）表达水平、浆细胞数量及肠黏液分泌型免疫球蛋白A（S-IgA）含量的变化。另取8只健康大鼠检测上述指标作为正常参考值。结果（1）与正常值比较，伤后EN组CD3^＋、CD4^＋、CD4^＋／CD8^＋降低但CD8^＋升高，与各项指标大部分时相点比较，差异有统计学意义（P〈0．05或P〈0．01）。伤后10d与EN组（CD4^＋／CD8^＋为1．26±0．10）比较，EIN组CD3^＋、CD4^＋、CD4^＋／CD8^＋（CD4^＋／CD8^＋为1．86±0．25）升高而CD8^＋下降（P〈0．01）。（2）伤后4、7、10d，EIN组肠黏膜PCNA表达水平、浆细胞数量及肠黏液S-IgA含量较EN组明显升高（P〈0．05或P〈0．01）。结论烫伤后早期给予肠内免疫营养，可以提高全身及肠道免疫功能，效果优于标准肠内营养。

The influence of early enteral immunonutrition on immunological function of body and intestine in severely scalded rats

OBJECTIVE: To investigate the influence of early enteral immunonutrition on immunological function of body and intestine in severely scalded rats. METHODS: Sixty-four healthy adult SD rats were subjected to 30% TBSA full-thickness scald and randomly divided into enteral nutrition group (EN, n = 32) and enteral immunonutrition group (EIN, n = 32). Another 8 healthy rats were enrolled as normal controls. The changes in CD3+, CD4+, CD8+ T lymhocyte subsets, the PCNA expression in intestinal mucosa,the amount of plasmocytes in lamina propia of small intestine and the content of s-IgA in small intestine were determined on 1, 4, 7 and 10 post-burn days (PBD). RESULTS: (1) CD3+, CD4+ and the ratio of CD4+/CD8+ were remarkably declined, while CD8+ was obviously raised after scald in EN group, and there were statistically significant differences at most of time-points when compared with those in control group (P < 0.05 or P < 0.01). CD3+, CD4+ and the ratio of CD4+/CD8+ on 7 and 10 PBD in EIN group were obviously higher (increased from 4 PBD on, and it was 1.86 +/- 0.25 on 10 PBD) than those in EN group (CD4+/CD8+ was 1.26 +/- 0.10 on 10 PBD), while CD8+ in EIN group was evidently lower than that in EN group (P < 0.01). (2) The level of PCNA expression in intestinal mucosa, the amount of plasmocytes in lamina propia of small intestine and the content of s-IgA in small intestine in EIN group were increased significantly compared with EN group on 4, 7, 10 PBD (P < 0.05 or P < 0.01). CONCLUSION: Early enteral immunonutrition can improve immunological function of body and intestine after severe scald, with better results than enteral nutrition.